Q&A: End-of-life care strategies

Q: When providing end-of-life care, what are some of the key strategies for case managers to consider?

A: One strategy that can help guide these end-of-life decisions involves using what Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, of EFS Supervision Strategies LLC in Burke, Virginia calls the 4 C's. The four C’s refer to the main areas where case managers will need to put their focus to ensure the best outcomes for all involved.

The four C’s are as follows:

• Capacity. To ensure capacity, the case manager should be able to determine whether the patient and others who are involved understand and are capable of making all needed plans and care decisions.
• Competence. Case managers should ascertain that the patient is mentally sound to make necessary decisions regarding end-of-life care. Keep in mind that an individual’s competence is established according to legal standards and the court, not by medical or behavioral health professionals, says Fink-Samnick.
• Coping. Care should be taken to ensure a plan is in place to support the patient’s emotional needs during this health journey.
• Choice. The case managers should ensure that the patient and family members are given clear choices regarding all elements of the process, including care, planning, and any potential alternatives.

 For more information on this topic, please see June's issue of Case Management Monthly.